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Introduction

Virtue is a fundamental ethical concept in society that revolves around developing positive character traits and moral excellence in individuals. It is rooted in the idea that ethical behaviour should be guided by rules and principles and by cultivating virtuous qualities such as honesty, compassion, courage, integrity, and wisdom (Papouli, 2019). Virtue ethics emphasises the importance of character development and the pursuit of a virtuous life as the foundation for making ethical decisions and living a morally upright existence. This ethical concept encourages individuals to aspire to be virtuous and good people, believing that such character traits will naturally lead to ethical behaviour and the betterment of society (Nguyen & Crossan, 2021).

Virtue related to healthcare

Virtue ethics, a framework emphasising the cultivation of moral virtues, is of paramount importance in the realm of healthcare. This perspective places virtues like empathy, compassion, integrity, and moral excellence at the forefront of healthcare practice, and its significance can be substantiated through compelling evidence (Butts & Rich, 2022). First and foremost, virtue ethics in healthcare leads to patient-centred care, a critical component of quality healthcare provision (Jakimowicz et al., 2018). A study by Gozalo et al. (2019) found that patients receiving care from healthcare providers who exhibited empathy and compassion reported higher levels of satisfaction and demonstrated improved health outcomes.

Moreover, virtue ethics fosters trust and confidence in healthcare professionals (Butts & Rich, 2022). Research by Hong & Oh (2020) indicates that trust in healthcare providers significantly influences patient compliance and satisfaction. When healthcare providers act virtuously, patients are more likely to trust their judgment and follow recommended treatment plans, leading to better health outcomes. Finally, practising virtue ethics contributes to the well-being of healthcare professionals (Papouli, 2019). A study by Chu (2023) suggests that incorporating virtue ethics into practice leads to higher job satisfaction and reduced burnout among healthcare providers. This positive impact on the professional well-being of healthcare workers underscores the value of virtue ethics in sustaining a motivated and ethical healthcare workforce.

Virtue critical to healthcare

Professional integrity, a pillar of virtue ethics, reinforces the ethical aspect of healthcare. This not only prevents unethical behaviours such as fraud and negligence but also upholds the overall integrity of the healthcare system (Leung & Ho 2020). A study by Groothuizen et al. (2018) underscores the significance of virtue ethics in maintaining trust and integrity within healthcare. Emphasising moral virtues like honesty, integrity, and accountability, healthcare professionals who embody these qualities maintain the highest standards of professional conduct.

Moreover, virtue ethics results in benefiting patients and healthcare providers. This enhances their quality of life and ensures they can provide better patient care. Healthcare professionals who exhibit virtuous behaviour experience higher job satisfaction reduced stress levels, and lower rates of burnout (Biagoli et al., 2018). Research by Komase et al. (2021) supports this, highlighting how incorporating virtue ethics into healthcare practice positively impacts healthcare providers' well-being and job satisfaction.

Relationship to professional code

The ethical concept of virtue is intricately interwoven with the International Council of Nurses (ICN) Code of Ethics, providing a robust ethical framework that guides the professional conduct of nurses and midwives across the world. Firstly, virtue ethics aligns with several fundamental principles in the ICN Code of Conduct, specifically in Code 1.9, which stipulates that nurses and midwives must provide safe and quality care (ICN, 2021). Virtue ethics underscores the importance of virtues like compassion and empathy, emphasising patient-centred care. This parallels Code 1.3, which highlights the duty to consider the needs and preferences of patients, promoting the cultivation of virtuous qualities that enhance patient interactions (ICN, 2021).

In addition, Codes 1.4 and 1.8 of the ICN's Code of Conduct emphasise the need for nurses and midwives to respect public trust, act honestly, and maintain professional integrity. By highlighting moral virtues like honesty and integrity as crucial elements of ethical character, virtue ethics complements this notion (ICN, 2021). The expectations indicated in Code 1.10 emphasise the duty of nurses and midwives to make ethical choices that prioritise patients' best interests, and virtue ethics plays a crucial part in ethical decision-making. Healthcare practitioners can negotiate complex ethical dilemmas with the help of virtue ethics as long as they uphold virtues like integrity, empathy, and moral courage (ICN, 2021).

Sources of ethical disagreements

Ethical disagreements surrounding the concept of virtue are rooted in the contrasting perspectives of absolutism, relativism, and pluralism. Absolutism contends that particular virtues possess inherent and universal value, transcending cultural and situational boundaries. For instance, honesty is often regarded as an absolute virtue in many ethical frameworks, with deviations from it seen as morally wrong across different cultures (Banks, 2020). Conversely, relativism argues that virtues are context-dependent and culturally influenced. What is considered virtuous in one cultural or situational context may not hold the same significance in another (Baghramian, 2019).

A study by Small & Lew (2021) has highlighted the variability of moral values, supporting the notion that virtues can be relative to specific cultures and settings. Within virtue ethics, pluralism recognises that ethical dilemmas may require the prioritisation of particular virtues over others based on the situation's complexities (Ratti & Graves, 2021). In healthcare ethics, for instance, balancing virtues like patient autonomy and beneficence can be challenging (Hem et al., 2018). Research by Gómez-Vírseda et al. (2020) has shown that cultural differences can significantly impact ethical decision-making, highlighting the need to navigate these complexities while considering absolutist and relativist perspectives.

Conclusion

In conclusion, virtue ethics is a fundamental tenet of healthcare, encouraging the growth of moral qualities like compassion and integrity. This moral framework encourages patient-centred treatment, increases confidence in medical practitioners, and improves their well-being, all of which ultimately result in better health results. The necessity for a complex approach to healthcare ethics is highlighted by ethical conflicts, regardless of whether they are based on absolutism, relativism, or pluralism. Virtue ethics reinforces safeguarding, professional integrity, and ethical decision-making principles by harmonising with the ICN Code of Ethics for nurses. It is a useful and priceless manual that improves patient care, supports moral principles, and advances society.

References

Baghramian, M. (2019, June). I—The virtues of relativism. In Aristotelian Society Supplementary Volume (Vol. 93, No. 1, pp. 247-269). Oxford University Press. https://doi.org/10.1093/arisup/akz013

Banks, S. (2020). Ethics and values in social work . Bloomsbury Publishing. https://books.google.co.in/books

Biagioli, V., Prandi, C., Nyatanga, B., & Fida, R. (2018). The role of professional competency in influencing job satisfaction and organizational citizenship behavior among palliative care nurses. Journal of Hospice & Palliative Nursing , 20 (4), 377-384. https://doi.org/10.1097/NJH.0000000000000454

Butts, J. B., & Rich, K. L. (2022). Nursing ethics: Across the curriculum and into practice . Jones & Bartlett Learning. https://books.google.co.in/books

Chu, A. (2023). Virtue Ethics in Nursing: A Review of the Literature. https://digitalcommons.liberty.edu/honors/1304

Gómez-Vírseda, C., De Maeseneer, Y., & Gastmans, C. (2020). Relational autonomy in end-of-life care ethics: A contextualized approach to real-life complexities. BMC Medical Ethics , 21 , 1-14. https://doi.org/10.1186/s12910-020-00495-1

Gozalo, R. G., Tarrés, J. F., Ayora, A. A., Herrero, M. A., Kareaga, A. A., & Roca, R. F. (2019). Application of a mindfulness program among healthcare professionals in an intensive care unit: Effect on burnout, empathy and self-compassion. Medicina Intensiva , 43 (4), 207-216. https://doi.org/10.1016/j.medine.2019.03.006

Groothuizen, J. E., Callwood, A., & Gallagher, A. (2018). NHS constitution values for values-based recruitment: A virtue ethics perspective. Journal of Medical Ethics , 44 (8), 518-523. http://dx.doi.org/10.1136/medethics-2017-104503

Hem, M. H., Gjerberg, E., Husum, T. L., & Pedersen, R. (2018). Ethical challenges when using coercion in mental healthcare: A systematic literature review. Nursing Ethics , 25 (1), 92-110. https://doi.org/10.1177/0969733016629770

Hong, H., & Oh, H. J. (2020). The effects of patient-centered communication: Exploring the mediating role of trust in healthcare providers. Health Communication , 35 (4), 502-511. https://doi.org/10.1080/10410236.2019.1570427

International Council of Nurses [ICN]. (2021). The ICN code of ethics for nurses. https://www.icn.ch/sites/default/files/2023-06/ICN_Code-of-Ethics_EN_Web.pdf

Jakimowicz, S., Perry, L., & Lewis, J. (2018). Insights on compassion and patient‐centred nursing in intensive care: A constructivist grounded theory. Journal of Clinical Nursing , 27 (7-8), 1599-1611. https://doi.org/10.1111/jocn.14231

Komase, Y., Watanabe, K., Hori, D., Nozawa, K., Hidaka, Y., Iida, M., & Kawakami, N. (2021). Effects of gratitude intervention on mental health and well-being among workers: A systematic review. Journal of Occupational Health , 63 (1), e12290.  https://doi.org/10.1002/1348-9585.12290

Leung, T. C., & Ho, J. C. (2020). Social Responsibility and Ethics in Health Care. Primary Care Revisited: Interdisciplinary Perspectives for a New Era , 225-240. https://doi.org/10.1007/978-981-15-2521-6_14

Nguyen, B., & Crossan, M. (2021). Character-infused ethical decision making. Journal of Business Ethics , 1-21. https://doi.org/10.1007/s10551-021-04790-8

Papouli, E. (2019). Aristotle’s virtue ethics as a conceptual framework for the study and practice of social work in modern times. European Journal of Social Work , 22 (6), 921-934. https://doi.org/10.1080/13691457.2018.1461072

Ratti, E., & Graves, M. (2021). Cultivating moral attention: A virtue-oriented approach to responsible data science in healthcare. Philosophy & Technology , 34 (4), 1819-1846. https://doi.org/10.1007/s13347-021-00490-3

Small, C., & Lew, C. (2021). Mindfulness, moral reasoning and responsibility: Towards virtue in ethical decision-making. Journal of Business Ethics , 169 , 103-117. https://doi.org/10.1007/s10551-019-04272-y

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